HomeMy WebLinkAboutBuilding Permit 99-1329
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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1/ /iz/11
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS 1f . J
J 0 19 '- Nl.L/I/l'"1.u../ 1 j
3. LEGAL DESCRIPTION
LOT )..7
fI -
ADDITION ,..j A IItAA1JL'/
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
4'Cf -1.32.- ~
1. DATE
.
{Vir
BUILDINC INFORMATION
11. SIZE OF STRUETURE
(Height) (Wirth) (Depth)
12. NO. OF STORlfS
13. TYPE OF CONfTAUCTION
14. FLOOR AREA fPPORTIONMENT USE
I
I
BLOCK
fi,..1 .
PID JS-I3.l.-0Jf.. 2.
4 ADRlItJJ(NamepLI RiER.
(Address) (TaL No.)
301"1' FAII<Vr;::wR:D 49-o-?; 2..66
5. ARCHITECT
(Name)
(Address)
6. BUILDER
(Name)
::: e. / c/"
(Address)
(Tal. No.)
(Tel. No.)
15. NUMBER OF ~CCUPANTS OR SEATS
OCCUPANTSI
I
SEATS
7. TYPE OF WORK Fireplace D Septic 0 Deckll Re-roofing 0 Porch D
New Construction LJ Alterations LI Addition LI Finish Attic LI Re-siding LI Finish Basement 0 16. PRO~T C,?~TNALUE
Chimney LJ Misc. #j :5 q 0
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETIO~DATE I
Sq. Ft. Width Depth Yes No l I 11 Z- '3/ l' oCJ
I hereby certify that I have tum. ished infonnation on this application which is to the best of my knowledge true and correct. I also certify that I am the o~ner or authorized agent tor
the above mention pro~e . will conform to all existing state and local laws and will proceed in accordance with submitted lans. I am aware that the
building official ,/Irevok nnit for ju cau urthermore, I hereby agree that the city official or a designee may enter upon the property to perf nn ne~ded)nspect1lns.
X ' . ~ Ill/V'?"'?
Signature license No. I 10ate I
I
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
II '2.a::>.OO
PEAMITVALUATION +A:~ ~ ,~G ,-:
Water Tap ...................................
Builder's Deposit ............................
Other .........................................
Total Due .............................. 67. 0'
Receipt Nc .?f. i.>1'1
Date 1/ - 11 J'j'i By {Job.
t In the above application and accompanYing documents IS In accordance With the City Zomng Ordinance and may proceed as reqrested ThiS document when
a temporary Certificate of Zom compliance and allows construction to commence Before occupancy, a Certificate of Oc upancy must be Issued
L
Oat Special Conditions ij any I
..,...,..._,_........~..L"..
USE QF BUILDING
Res; ,4/ e...
TYPE OF CONSlllUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee. ......... ........ ................. ~
LlD. '2 c.;
'2.lt> . 111
~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... ~
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ........"........... $
~
Y r Building pennitrr:.n/~!?~
Date ~ ' '1~
Issued
TT;l" ~~~requ
slg byt ~~ner
City Planner
24 hour notice for all inspections 447.9850
Side
MATERIAL FILEC WITH APPLICATION
SOIL TESTS LJ E JERGY DATA LJ
PILING LOGS 0 P ::RCOLATION TESTS 0
PLANS & SPECS 0 S ;TS
SURVEY 0 C )PIES
PLOT PLAN 0
Amount Brought Forward ..................
Pari<: Support Fee ...........................
SAC .........................................
Collective Street Fee .......................
Sewer Tap .... ..... .... .... .... ......... .....
Pressure Reducer ... .... .... ...............
Meter Ham ... .... .... ......... .... .... .......
Water Meter. .... ............................
Sewer & Water Connection Fee ...........
Water Tower Fee ...........................
Paid
~~
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.. I
While . ~uilding
Canary - :ngineering
Pink - >Ianning
Thr(."rnlnoflhrl,.krCounlry
BUILDING PERIVlILAPPLlCATION DEPARTMENT CHECKLlSI
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the buildillg permit
application for construction activity which is proposed at:
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Accepted \/
:::::~ By ().ll ~ 0". Ji-I7-<f~
Comments:. ~ ~ I rtpi >.c1J;ode- ~ q/LI .
~'fVI(J .~!7:k(t0 OIL. /J1)~ 'w ~
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Accepted With Corrections
"The issuance or granting of a permit or approval of plans, specificat ons and
computations shall not be construed to be a permit for, or an approval of, any v alation of
any of the provisions of this code or of any other ordinance of the jurisdiction, Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
ATTACHMENT A TO BUILDING PERMIT NO.
qq. \S1-(
PROPERTY OWNER ACKNOWLEDGMENT FOR NEW CONSTRUCTI( iN
The Owner of property at ;>:'0\ "( FA i(L\! 16-..1 ~ in the City ofPrio:
Lake has applied to the City for a Building Permit to construct new addition or deck.
Prior Lake City Code Section 4-1-7 (A) requires a Certificate of Survey, prepared by a
registered land surveyor, as part of the Building Permit application for all new
construction. The Owner has requested an exemption from the Certificate of Survey
requirements as provided for in Section 4-1-7 (D) and (E). In consideration of the Ci ty
accepting a marked site plan or survey in lieu of a new Certificate of Survey, the Ow ler
hereby agrees to waive any claims against the City and to hold the City hannless frOl a
any claims or damages incurred if the structure is inaccurately placed on the site.
DATE: / ~/)~~
OWNER(S):
L~
::~YOF~._ \,
Its 13", I uJr ^""' DA4 U/1 '-- ------.."
STATE OF MINNESOTA)
) ss.
COUNTY OF >P-O" )
The foregoing instrument was acknowledged for me this
/!/eVt-J>?et:.-1? ,199'2.., by !Zo/3G,Lr D f/~r<-I;'A->
Official of the City of Prior Lake and A DIZi/iJJ Po.L{';~
owners.
/77/1 day of
, The Building
he
.~L
No~lic
'"".4......1..." II lll............,
. UNDAAUEN '
, llOrMYPU&IC'''UIOf~ 1
_., I, ___31, ~
HOLDHARMDOC
PRIOR LAKE
INSPECTION
SITEADDRESS'f1IQ f!~E~D
TYPE OF WORK T::tr Ie-
USE OF BUILDING C:;;Ph
PERMIT NO. q 9 - (-::r 2.. Cj
BUILDER ';::;\,1-", r-
NOTE: THIS IS NOT A PERMIT FOR ANY OE if HE INSPECTION 3 BELOW
THE PERMIT IS BY SEPARATE DO;: L_J
, FOOTING I. ~ f/tn I CiJkA
. ~LACE NO CONCRETE UNTIL ABO\:"H'AS BEEN ~IGtIEti
'4)I,y.;.~lj( I I 1 I
/f'" I
/ I .
I FINAL H1t /I//f~
DEPARTMENT OF
BUILDING AND INSPI:CTION
DATE ISSUED /1-1 S- -'1'1
. .
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIllE
/#fir
~
ADDRESS
Jc//9 h,)-v~e"--'
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
~TE INSPECTION
COMMENTS:
Pee/
~
( ~/
~/IC)S~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
t79 - L,.?.29'
, .
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/ / /
(t7~Jd/~ re..
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hORK SATISFACTORY. PROCEED
/;;- ~ORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ j Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSJIOTI